Forms – Oak Cliff Pediatrics

ADHD/ADD Forms

Prior to your first ADHD/ADD visit please fill out the initial Vanderbilt forms. Complete and return the NICHQ Vanderbilt Assessment Scale from both parent and teacher prior to the first appointment. Save the “Follow Up Assessment” to be submitted before the child’s 2nd ADHD visit.

How can you get the forms to us?

Please drop all forms off at the office or email to admin@oakcliffpediatrics.com. Please email and allow 48 hours for the physician to review the forms prior to your appointment.

DOWNLOAD FORM

Camp and School Forms

We will gladly complete these forms for you. In order to do this, your child should have a well child visit within the past 12 months. Visits for an illness address a specific problem and are not ordinarily comprehensive enough for us to complete these forms. Beginning February 1st 2022, OCP will be charging $10 per camp form and or school form, if the form is not completed at the well child exam. If the patient form is dropped off or emailed and asked to be completed the same day, the charge will be $25 per form.

How can you get the forms to us?

Please drop all forms off at the office or email to admin@oakcliffpediatrics.com. We will include a copy of your child’s shot record with your form. Please allow for a 48 hour return.

DAYCARE FORM TAAPS FORM DISD/UIL FORM

Release of Medical Records for New Patients

Please fill out the form, sign and return to the clinic before your first appointment. We will need 5 business days to obtain your records from your previous clinic in order to receive vaccines.

How can you get the forms to us?

Please drop all forms off at the office or email to admin@oakcliffpediatrics.com.

DOWNLOAD FORM